Systematic review and meta-analysis of psychological interventions to promote treatment adherence in children, adolescents, and young adults with chronic illness

J Pediatr Psychol. 2014 Sep;39(8):918-31. doi: 10.1093/jpepsy/jsu038. Epub 2014 Jun 20.


Objective: This meta-analysis examined the effectiveness of recent adherence-promoting interventions for youth with chronic health conditions.

Methods: Peer-reviewed randomized controlled trials of adherence-promoting interventions for youth with a chronic illness published between 2007 and 2013 (n = 23) were reviewed. Intervention delivery (in-person vs. technology-based) and outcome measurement (e.g., self-report) were examined as potential moderators of treatment effects.

Results: Mean effect sizes were small at posttreatment (d = 0.20, 95% confidence interval (CI): 0.08, 0.31, n = 23) and follow-up (d = 0.29, 95% CI: 0.15, 0.43, n = 9). Intervention delivery and outcome measurement did not account for variation in treatment effects (p > .05).

Conclusions: The small treatment effects of recent adherence-promoting intervention (APIs) reflect the methodological limitations of the included studies and the need to reexamine the delivery and mechanisms of adherence-promoting interventions.

Keywords: adherence; chronic illness; computer applications/eHealth; effect size; meta-analysis.

Publication types

  • Meta-Analysis
  • Research Support, N.I.H., Extramural
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Behavior Therapy / methods*
  • Child
  • Child, Preschool
  • Chronic Disease / drug therapy*
  • Chronic Disease / psychology*
  • Female
  • Humans
  • Male
  • Patient Compliance / psychology*
  • Young Adult